Cardiac Symptoms And Conditions Flashcards
What is true of most syncope events?
They are benign
What factors point to cardiac syncope?
- Sudden onset without any prodromal period of dizziness or imminent awareness
- Syncope during exercise or exertion
- Complete loss of awareness and muscle tone so that fall results in injury
- Palpitations or abnormal heartbeat noted before the event
- Abnormal heart rate (fast or slow) after the event
- Family history of cardiovascular disease at early age, or sudden death
What do cardiac causes of sudden death in the young occur due to?
Ventricular fibrillation in the setting of myocardial or coronary abnormalities, or primary rhythm disorders
What are the main structural causes of cardiac sudden death?
- Hypertrophic cardiomyopathy
- Anomalies of the coronary artery
- Marfan’s syndrome
- Arrhythmogenic right ventricular dysplasia
What can cause abnormal coronary arteries?
Kawasaki syndrome
What primary rhythm disorders might cause sudden cardiac death?
- Prolonged QT syndrome
- Wolff-Parkinson-White syndrome
Which children are at higher risk of sudden cardiac death?
Those with congenital heart disease
What is Kawasaki disease?
Vasculitis of small to medium vessels
What is the aetiology of Kawasaki disease?
Unknown
Why is Kawasaki disease an important condition?
It is a leading cause of acquired heart disease in children
At what age is Kawasaki disease most common?
6 months - 4 years
What are the clinical features of Kawasaki’s disease?
Fever for more than 5 days with at least 4 of -
- Polymorphous rash
- Lymphadenopathy
- Conjunctivitis
- Mucositis
- Oedema of hands and feet with subsequent desquamation
What can complicate kuivasalie disease?
Coronary arteritis and aneurysm formation
Which patients are at increased risk of infective endocarditis?
- Acquied valvular heart disease with stenosis or regurgitation
- Valve replacement
- Structural congenital heart disease
- Hypertrophic cardiomyopathy
- Previous infective endocarditis
What does the category of ‘structural heart disease’ as a risk factor for infective endocarditis include?
Surgically corrected or palliated structural conditions
What does the category of ‘structural heart disease’ as a risk factor for infective endocarditis exclude?
- Isolated ASD
- Fully repaired PDA or VSD
- Closure devices that are judged to be fully endotheliased
When is the risk for infective endocarditis highest?
- Congenital heart disease where there is turbulent jet of blood
- Artificial prosthetic material within or outside of the heart
- Repetitive IV drug use
Is antibiotic prophylaxis recommended for infective endocarditis?
No
How is infective endocarditis prevented?
- Good dental hygiene
- Avoidance of invasive procedures, including body piercing and tattooing
How common is rheumatic fever?
Rare in the UK, but important cause of acquired heart disease worldwide
What is rheumatic fever?
Inflammatory disease involving the joints and heart,and less frequently, the CNS, skin, and subcutaneous tissues
What causes then mat-i fever?e
It is a complication of group A beta haemolytic streptococcus
Who does rheumatic fever affect?
Children 5-15 years of age (peak age 8 years)
What does rheumatic fever occur following?
An upper respiratory tract infection
What happens between having an upper respiratory tract infection and developing rheumatic
Fever?
A 2-6 week latent period
Who is the incidence of rheumatic fever higher in?
People living in crowded conditions
What implies a genetic influence in rheumatic fever?
Family clustering occurs
What happens in the early stages of rheumatic fever?
There is an inflammatory exudative reaction
How does the initial inflammatory exudative reaction last in rheumatic fever?
2-3 weeks
What does the initial inflammatory exudative reaction in rheumatic fever involve?
Myocardium, values, and pericardium
Which valves are most commonly affected in rheumatic fever?
Mitral most commonly, then aortic
What follows the acute inflammatory phase in rheumatic fever?
A proliferative phase
What happens in the proliferative phase of rheumatic fever?
Aschoff bodies form
What do Aschoff bodies consist of?
Perivascular infiltrations of large cells with polymorphous nuclei and basophilic cytoplasm arranged in a rosette around an avascular centre of fibrinoid
What is the significance of Aschoff bodies?
They are pathognomonic for rheumatic fever
